Form ID

Publication date

Location of premises

Certificate

Watermain Replacement

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
City of Toronto, Works & Emergency Services, Technical Services, District 2
Address of Owner
399 The West Mall, Etobicoke, ON M9C 2Y2
Name of Contractor
614128 Ontario Ltd. o/a Trisan Construction
Address of Contractor
P.O. Box 502, Schomberg, ON L0G 1T0
Name of Certifier
Tom Ellerbusch, P.Eng. Manager, Design & Construction
Address of Certifier
as owner

Office to which claim for lien must be given to preserve lien

City Clerk, Metro Hall, 55 John Street, Toronto, ON M5V 3C6